Question

A 33-year-old patient comes to see you as she has noticed an itchy rash on both elbows. It has been worsening for the past week. On examination, you see a multiple polygonal, flat-topped papular lesions that each measure 5mm diameter on the flexural surface of her elbows, bilaterally. She has no other rash on the rest of her body. Which one of the following is the most likely diagnosis?

Answer 1

Based on the symptoms described, the most likely diagnosis is Lichen Planus, a skin condition that often presents as itchy, polygonal, flat-topped lesions, typically bilaterally and symmetrically on the flexural surfaces.

Step-by-step explanation:

From the description of the patient's symptoms given, the most likely diagnosis is Lichen Planus. Lichen Planus is a condition that can cause swelling and irritation in the skin, hair, nails, and mucous membranes. On the skin, lichen planus usually appears as purplish, often itchy, flat-topped bumps. The condition tends to affect the flexural surfaces, like the elbows and wrists, and the lesions typically occur bilaterally and symmetrically, matching the scenario described.

Other possible conditions with similar symptoms, like psoriasis or eczema, involve different presentation patterns and other body parts besides just the elbows, increasing the unlikelihood of them being the right diagnosis in this case.

As always, the definitive diagnosis would need to be made by a healthcare provider possibly using skin biopsy or other techniques, as necessary.

Learn more about Lichen Planus